Dementia Patients
Conditions
Brief summary
Both visual impairment and dementia are prevalent in the elderly population. Cognitive stimulation therapy (CST) is an evidence-based intervention for people with mild-to-moderate dementia. Virtual reality (VR) has been used in cognitive rehabilitation. However, the efficacy of CST and the feasibility of incorporating VR into therapy targeting people with dementia and visual impairment (PwDVI) have rarely been explored. The current pilot study addressed two issues: 1) To study the efficacy of conventional CST on PwDVI in different cognitive domains and 2) To explore the feasibility and efficacy of VR-CST on PwDVI in various cognitive domains.
Interventions
BEHAVIORALVirtual reality based Cognitive Stimulation Therapy (VR-CST)
In the VR-CST condition, participants wore a head-mounted display (HMD; model: DPVR P1 Pro Headset) for the themed activities in every session except sessions 1 and 14. In these two sessions, group physical activities (such as passing a ball from one participant to another) were conducted, so no HMDs were used. In other sessions, panoramic images (e.g., wet market) and videos (e.g., the neighborhood surroundings) prepared by the project team were mainly used, supplemented by 2-dimensional images /videos in which preparing panoramic images/videos was deemed impossible. Such a situation occurred in Session 5 (current affairs), in which news clips or captions from newspaper websites served as more appropriate content for discussion than self-created panoramic images/videos.
BEHAVIORALConventional Cognitive Stimulation Therapy (Conventional CST)
In the conventional CST group, 2-dimensional images/videos illustrating content identical to the VR-CST condition were displayed via tablet computers (see Table 2 for details) in which participants could manipulate the size of the image depicted or the pace of the videos with the help of the facilitator/therapy assistant.
Sponsors
The University of Hong Kong
The Hong Kong Society for the Blind
Tung Wah College
The Hong Kong Polytechnic University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Cantonese speakers; 2. suspected or having a medical diagnosis of dementia, with the Montreal Cognitive Assessment 5-minute protocol (MoCA-5) score ranging from 2 to 17, which is equal to the Cantonese Mini Mental State Examination (MMSE) score ranging from 10 to 24 by using the conversion table from Wong et al, 3. a diagnosis of mild to moderate visual impairment determined by an optometrist, 4. no other disability including physical illness, learning disability and severe hearing impairment that may affect participation in group activity, 5. not currently on psychiatric medication/cognitive intervention, (6) no history of other neurological diseases, and (7) did not receive any prior CST.
Exclusion criteria
1. currently on psychiatric medication/cognitive intervention, (6) no history of other neurological diseases, 2. currently on psychiatric medication/cognitive intervention, (6) no history of other neurological diseases, 3. prior exposure to CST
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Hong Kong version of the Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI) | The assessment was administered three times 15 days before and after treatment. | It is a standarized assessment for global cognition for people with visual impairment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Holden Communication Scale | It was administered once one week before and after the intervention. | It is a questionnaire to evaluate the participants' communication and social behavior from a caregiver's perspective. Ratings were given by the formal carers of the old age homes for the visually imapired. |
| Cantonese version of the Amsterdam-Nijmegan Everyday Language Test (CANELT) | Three times 15 days before and after treatment | The test portrays 20 real-life situations encompassing different communicative functions, was conducted to evaluate functional communication quantitively. Scores were given based on the accuracy and completeness of the main concepts produced by the subjects. |
| Procedural description of making a ham-and-egg sandwich | The assessment was administered three times 15 days before and after treatment. | A picture depicting a loaf of bread, ham and an egg were presented to the subject and s/he will be asked to describe the procedures of making an egg-and-ham sandwich as detailed as possible. |
| Synonym judgement | The assessment was administered three times 15 days before and after treatment. | A pair of words were presented auditorily and the participants were asked to judge if the pair of words were synonymous or not. |
Countries
Hong Kong
Outcome results
None listed